| Primary Health Choice, Inc. | |
|
4701 Fayetteville Rd Lumberton NC 28358-2697 | |
| (910) 738-3939 | |
| (910) 738-3938 |
| Full Name | Primary Health Choice, Inc. |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 4701 Fayetteville Rd, Lumberton, North Carolina |
| Authorized Official Name and Position | Ashley Locklear (CFO) |
| Authorized Official Contact | 9108653500 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Primary Health Choice, Inc. Po Box 159 Saint Pauls NC 28384-0159 Ph: (910) 865-3500 | Primary Health Choice, Inc. 4701 Fayetteville Rd Lumberton NC 28358-2697 Ph: (910) 738-3939 |
| NPI Number | 1598903072 |
|---|---|
| Provider Enumeration Date | 01/22/2009 |
| Last Update Date | 04/28/2021 |
| Certification Date | 04/28/2021 |
| Medicare PECOS PAC ID | 3173679180 |
|---|---|
| Medicare Enrollment ID | O20090916000431 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598903072 | NPI | - | NPPES |
| 018J8 | Other | NC | BLUE CROSS BLUE SHIELD |
| 5906542 | Medicaid | NC | |
| 6005252 | Medicaid | NC |
| Provider Name | Ella O Lynch |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184611139 PECOS PAC ID: 5092720003 Enrollment ID: I20060213000538 |
| Provider Name | Laurie Kaufmann |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1942545850 PECOS PAC ID: 1557515467 Enrollment ID: I20130130000363 |
| Provider Name | Tanya Nicole Goodwin |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1184052953 PECOS PAC ID: 0143500330 Enrollment ID: I20170710000080 |
| Provider Name | Leah G Lewis |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1194219444 PECOS PAC ID: 8921427592 Enrollment ID: I20200930003201 |
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